Following ten previous international symposia on the theme of thrombolytic treatment of acute ischemic stroke, The New York Academy of Sciences (NYAS) is hosting the 11th meeting in this series: Thrombolysis and Acute Stroke Treatment (TAST) 2011: Forward to Acute Stroke Treatment in 2021. Organized by Drs. del Zoppo (PI of this grant and co-founder of this series) and Alexandrov, the Scientific Committee, Drs. Marler, Mori, and Kaste, and an International Advisory Board, this three-day conference will be held at NYAS Conference Center in New York, on 1-3 December, 2011. The goals of the symposium are to: (i) provide a neutral forum to a) generate provocative and forward-looking discussions about the state-of-the-art and future directions of research and clinical practice in the acute treatment of ischemic stroke, and b) better understand what the future holds for stroke research and patients ten years for now;(ii) highlight the research contributions of young investigators working in this field;and (iii) develop high-quality print and electronic enduring materials reporting the meeting presentations to the global scientific community. The program will feature keynote and directed plenary lectures, two mini-symposia, and a hands-on workshop, and incorporate plenty of time for networking, and audience and panel discussions. These will lead to vigorous interactions. Speakers will be explicitly asked to respond to a set of questions during their presentations to foster the generation of data-driven, multidisciplinary and focused ideas, explore ischemic stroke as a systemic disease related to other disease entities, and better address the evolution of the brain injury. Highlighted topics include: (i) the neurovascular unit and its injury;(ii) the safety and efficacy of thrombolytic agents currently used or being developed for acute stroke treatment;(iii) new views of the penumbra;(iv) time window considerations and optimized delivery conditions;(v) stabilization of brain tissue for patient recovery;(vi) enhancing the safety of plasminogen activators;(vii) factors that influence risk and benefit;and (viii) alternative approaches. We anticipate wide participation (250-300 attendees) from within and outside the immediate area of cerebrovascular disease, from basic research to clinical settings worldwide. The incorporation of poster and short presentations selected from submitted abstracts into the agenda, and the availability of discounted registration prices and travel fellowships will encourage participation from minority and young investigators. Previous meetings in the US in this series have occurred in La Jolla (1992) and Bethesda (1998), undertaken by the Scripps Clinic and Research Foundation and by the NINDS/ University of Cincinnati, respectively. Given the success in those, the timely and relevant topic, and the scientific rigor of our organizers and advisors, we anticipate a strong turnout to witness these live and enduring discussions, which will foster cross-disciplinary collaborations to promote improved treatment management, new research ideas and directions, and future guidelines for acute treatments of ischemic stroke. PUBLIC HEALTH RELEVANCE: A three-day, scientific conference at the New York Academy of Sciences will provide a neutral forum for clinicians and scientists, experts in cerebrovascular disease and related disorders, to generate provocative and forward-looking discussions to better articulate how clinical and basic science can advance blood flow restorative treatments and medical support in the coming ten to fifteen years, to promote and improve acute treatment of ischemic stroke. The program's cross-disciplinary discussions will approach ischemic stroke as a systemic disease, recognizing the contributions of hypertension, diabetes, and disorders of aging, beyond the conventional targets of time from symptoms onset to deeper understanding of basic mechanisms and the advanced science of clinical trials. This forum will also generate enduring print and online publications to highlight these discussions and make them available to the global scientific community and the general public, foster cross-disciplinary dialogue and collaborations, and promote attention toward the future medical care of stroke patients. 1